Adolescent Depression and Suicide

Question 1

How many americans in 10 take antidepressants?

Answer 1

1 in 10 aged 12 and up

Question 2

Which gender is more likely to take antidepressants?

Answer 2

females are 2.5 times more likely than males (nearly a quarter in the 40-59 range!)

Question 3

Describe how antidepressant use is culturally bound?

Answer 3

white people are much more likely to take them than hispanics and blacks, regardless of SES

Question 4

Over 80% of the psychiatric meds prescribe in MN are from what providers?

Answer 4

primary care

Question 5

What is the prevalence of suicide in general in the US?

Answer 5

12 per 100,000 (the 2nd leading cause of death under age 18)

Question 6

What group is most at risk for suicide?

Answer 6

white males over 85 (47 per 100,000)

Question 7

In American Indian populations, what age group is most at risk?

Answer 7

youth - ages 15 to 24

Question 8

What are the four major mood disorders described in the DSM?

Answer 8

major depressive disorder
persistent depressive disorder
bipolar 1 and 2
disruptive mood dysregulation disorder

Question 9

What are the two main “bolded” signs of major depression?

Answer 9

1. persistent sadnes or irritable mood in children

2. loss of interest in activities once enjoyed

Question 10

THen what are the “non-bolded” signs of major depression?

Answer 10

1. significant change in appetite or weight
2. difficulty sleeping or oversleeping
3. psychomotor retardation
4. loss of energy
5. feelings of worthlessness or inappropriate guilt
6. difficulty concentrating
7. recurrent thoughts of death/suicide

Question 11

How long does the depressed mood have to last to be given a persistent depressive disorder (dysthymia) diagnosis?

Answer 11

at least 2 years (one year in adolescents and kids)

Question 12

What is the difference between bipolar 1 and 2?

Answer 12

bipolar 1 - mania for 7 days

bipolar 2 - hypomania 4 days

Question 13

Why was the new diagnosis of disruptive mood dysregulation disorder created?

Answer 13

in an effort to distinguish between kids who hav emood dysregulation and those who actually have bipolar disorder

Question 14

What are the signs/characteristics of disruptive mood dysregulation disorder?

Answer 14

1. severe recurrent tempter tantrums that are inconsistent with developmental age and occur 3+ times a week.
   mood between outburts irritable or angery. criteria have to be present at least 1 year and in 2 settings (restricted to age 6-18 and onset has to be before 10)

Question 15

What grade in high school has particular problems with depression?

Answer 15

9th

Question 16

What are the pharmacology recommendations for depression in adolescents?

Answer 16

SSRIs should be reserved for moderate to severe depression and keep close contact during first few months
TCAs contraindicated
maintain treatment for at least 1 year

Question 17

What are the three goals of CBT?

Answer 17

1. challenge maladaptive beliefs
2. enhance problem-solving abilities
3. increase social competence

Question 18

What are the common adverse side effects of SSRIs?

Answer 18

restlessness, dizziness, drowsiness, GI ditress, headache, tremor

Question 19

What did the TADS student determine about treatment of depression in adolescents?

Answer 19

they found that CBT and fluoxetine alone had the same efficacy after a longer period of time, but using them in combo worked much faster

Question 20

In addition to the faster efficacy, what is another benefit of combined CBT and drugs?

Answer 20

Having CBT also decreases the risk for suicide

Question 21

What is the recommended length of treatment for combined therapy?

Answer 21

6-9 months

Question 22

What are the 7 PREDISPOSING factors for adolescent suicide

Answer 22

1. previous attempt
2. psychiatric disorder
3. sexual or physical abuse
4. exposure to violent behavior
5. fam hx of suicide or mood disorder
6. male gender
7. gay or lesbian

Question 23

What are the 4 PRECIPITATING factors for adolescent suicide?

Answer 23

1. substance abuse
2. prior suicide attempt
3. access to firearms
4. social stress or emotional factors

Question 24

In what group is postpartum depression practically the norm?

Answer 24

in adolescent mothers - 56% report moderate to severe PPD symptms that persist up to 4 years!